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General NPI Number Information
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NPI Number | 1730422676
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Entity Type | Organization
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Legal Business Name | JOHN HENRY FOUNDATION
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Dates
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Enumeration Date | 03/28/2013
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Last Update Date | 05/16/2013
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Provider Practice Location Address
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Address Line | 403 N SUSAN ST
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City | SANTA ANA
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State | CA
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Zip | 92703-3433
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Country | US
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Telephone | 714-554-8906
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Fax | 714-554-8770
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Provider Business Mailing Address
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Address Line | 403 N SUSAN ST
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City | SANTA ANA
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State | CA
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Zip | 92703-3433
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Country | US
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Telephone | 714-554-8906
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Fax | 714-554-8770
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. MINDY ANDREWS
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Credential |
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Telephone | 714-554-8906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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